TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population
The debate regarding the cutoff point in the treatment of patients with subclinical hypothyroidism (Shypo) is ongoing. Generally, two different groups are identified for treatment by levels of 10 and 20 mIU/L. Nevertheless, the question remains, “what cutoff point should be chosen?” We have written...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/2698627 |
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| author | Laura Pérez-Campos Mayoral María Teresa Hernández-Huerta Gabriel Mayoral-Andrade Eduardo Pérez-Campos Mayoral Edgar Zenteno Ruth Martínez-Cruz Héctor Martínez Ruíz Margarito Martínez Cruz Alma Dolores Pérez Santiago Eduardo Pérez-Campos |
| author_facet | Laura Pérez-Campos Mayoral María Teresa Hernández-Huerta Gabriel Mayoral-Andrade Eduardo Pérez-Campos Mayoral Edgar Zenteno Ruth Martínez-Cruz Héctor Martínez Ruíz Margarito Martínez Cruz Alma Dolores Pérez Santiago Eduardo Pérez-Campos |
| author_sort | Laura Pérez-Campos Mayoral |
| collection | DOAJ |
| description | The debate regarding the cutoff point in the treatment of patients with subclinical hypothyroidism (Shypo) is ongoing. Generally, two different groups are identified for treatment by levels of 10 and 20 mIU/L. Nevertheless, the question remains, “what cutoff point should be chosen?” We have written a selective nonsystematic review focused on the 97.5 percentile reference value reported in healthy subjects in a number of countries and observed important disparities, which partly show the challenge of identifying a single cutoff point for those patients needing medication. We identified studies of TSH on the natural history of subclinical hypothyroidism from population-based prospective cohort studies, which follow up patients for several years. The evolution of TSH levels in these patients is variable. Some cases of TSH may return to lower levels at different stages over the years, but others may not, possibly even developing into overt thyroid failure, also variable. We analyzed factors that may explain the normalization of serum TSH levels. In addition, we found that thorough population-based prospective cohort studies following up on TSH levels, thyroid antibodies, and ultrasonography are important in decisions made in the treatment of patients. However, the 97.5 percentile reference value varies in different countries; therefore, an international cutoff point for subclinical hypothyroidism cannot be recommended. |
| format | Article |
| id | doaj-art-e021af41d7824aac907652e77bd0e29b |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-e021af41d7824aac907652e77bd0e29b2025-02-03T06:46:41ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/26986272698627TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the PopulationLaura Pérez-Campos Mayoral0María Teresa Hernández-Huerta1Gabriel Mayoral-Andrade2Eduardo Pérez-Campos Mayoral3Edgar Zenteno4Ruth Martínez-Cruz5Héctor Martínez Ruíz6Margarito Martínez Cruz7Alma Dolores Pérez Santiago8Eduardo Pérez-Campos9Centro de Investigación Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juírez de Oaxaca, Oaxaca 68020, MexicoCONACyT Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca 68020, MexicoCentro de Investigación Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juírez de Oaxaca, Oaxaca 68020, MexicoCentro de Investigación Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juírez de Oaxaca, Oaxaca 68020, MexicoFacultad de Medicina de la Universidad Nacional Autónoma de México, Ciudad de México 04510, MexicoCentro de Investigación Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juírez de Oaxaca, Oaxaca 68020, MexicoCentro de Investigación Facultad de Medicina UNAM-UABJO, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juírez de Oaxaca, Oaxaca 68020, MexicoTecnológico Nacional de México/IT de Oaxaca, Oaxaca 68030, MexicoTecnológico Nacional de México/IT de Oaxaca, Oaxaca 68030, MexicoTecnológico Nacional de México/IT de Oaxaca, Oaxaca 68030, MexicoThe debate regarding the cutoff point in the treatment of patients with subclinical hypothyroidism (Shypo) is ongoing. Generally, two different groups are identified for treatment by levels of 10 and 20 mIU/L. Nevertheless, the question remains, “what cutoff point should be chosen?” We have written a selective nonsystematic review focused on the 97.5 percentile reference value reported in healthy subjects in a number of countries and observed important disparities, which partly show the challenge of identifying a single cutoff point for those patients needing medication. We identified studies of TSH on the natural history of subclinical hypothyroidism from population-based prospective cohort studies, which follow up patients for several years. The evolution of TSH levels in these patients is variable. Some cases of TSH may return to lower levels at different stages over the years, but others may not, possibly even developing into overt thyroid failure, also variable. We analyzed factors that may explain the normalization of serum TSH levels. In addition, we found that thorough population-based prospective cohort studies following up on TSH levels, thyroid antibodies, and ultrasonography are important in decisions made in the treatment of patients. However, the 97.5 percentile reference value varies in different countries; therefore, an international cutoff point for subclinical hypothyroidism cannot be recommended.http://dx.doi.org/10.1155/2020/2698627 |
| spellingShingle | Laura Pérez-Campos Mayoral María Teresa Hernández-Huerta Gabriel Mayoral-Andrade Eduardo Pérez-Campos Mayoral Edgar Zenteno Ruth Martínez-Cruz Héctor Martínez Ruíz Margarito Martínez Cruz Alma Dolores Pérez Santiago Eduardo Pérez-Campos TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population International Journal of Endocrinology |
| title | TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population |
| title_full | TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population |
| title_fullStr | TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population |
| title_full_unstemmed | TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population |
| title_short | TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population |
| title_sort | tsh levels in subclinical hypothyroidism in the 97 5th percentile of the population |
| url | http://dx.doi.org/10.1155/2020/2698627 |
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